Borralho P, Cunha F, Pinto M, da Silva A T, Meirinho M
Serviço de Anatomia Patológica, Hospital Garcia de Orta, Almada.
Acta Med Port. 1996 Oct-Dec;9(10-12):319-23.
Infection of the embryo and foetus remains a major public health problem. It has been widely accepted as a major cause of spontaneous abortion, premature birth and morbidity and mortality of the newborn. Furthermore, many studies stress the role of chorioamnionitis in the onset of premature labor. We have found a significant incidence of chorioamnionitis in placentas examined in our laboratory, but we do not know the real prevalence of intra amniotic infection and the magnitude of its consequences. Furthermore, there is no data concerning the micro-organisms that can act as pathogens in our patients. The aim of this study was to better define the role of infection in pregnancy in our hospital. As a first approach we studied all the placentas that were sent to the Histopathology Department during 1993, trying to correlate histological findings with clinical data. We found that 38% of 280 placentas had histological criteria for chorioamnionitis, 33% of which were associated with fetal death. Only 13% of these cases had clinical signs of infection. These facts stress the need for a sensitive and selective method of identifying organisms that act as pathogens in intrauterine infection. It may be possible to prevent some of its complications if an earlier diagnosis and identification of the agent are done.
胚胎和胎儿感染仍然是一个重大的公共卫生问题。它已被广泛认为是自然流产、早产以及新生儿发病和死亡的主要原因。此外,许多研究强调绒毛膜羊膜炎在早产发作中的作用。我们在实验室检查的胎盘中发现绒毛膜羊膜炎的发生率很高,但我们不知道羊膜腔内感染的实际患病率及其后果的严重程度。此外,关于在我们的患者中可作为病原体的微生物,尚无相关数据。本研究的目的是更好地确定感染在我院妊娠中的作用。作为第一步,我们研究了1993年送往组织病理学部门的所有胎盘,试图将组织学发现与临床数据相关联。我们发现,280个胎盘中有38%具有绒毛膜羊膜炎的组织学标准,其中33%与胎儿死亡有关。这些病例中只有13%有感染的临床体征。这些事实强调需要一种灵敏且有选择性的方法来识别在宫内感染中作为病原体的微生物。如果能更早地诊断和识别病原体,或许有可能预防其一些并发症。